Ventilator-associated pneumonia and antimicrobial susceptibility of microorganisms isolated from patients in the intensive care unit of a public hospital in Minas Gerais
DOI:
https://doi.org/10.34019/1982-8047.2021.v47.34013Keywords:
Ventilator-Associated Pneumonia, Drug Resistance Bacterial, Intensive Care UnitsAbstract
Introduction: The ventilator associated pneumonia (VAP) is the main infection related to health care in intensive care units (ICUs), with antimicrobial resistance a growing threat. Objective: To determine the etiology of VAPs and the susceptibility profile of microorganisms to antimicrobials in the adult ICU of the Municipal Hospital of Governador Valadares – MG (MHGV). Material and Methods: A retrospective study was carried out in order to seek results from cultures of tracheal secretion and bronchoalveolar lavage performed by the clinical analysis laboratory of MHGV from September/2018 to August/2019. VAP was considered when at least 106 colony-forming units (CFU)/mL were found in the endotracheal aspirate and 104 CFU/mL in the bronchoalveolar lavage. In addition, the hospital’s infection control committee provide some data on VAPs for the period from January to December 2017. Results: There were 29 episodes of monomicrobial VAP. The main agents were Klebsiella pneumoniae (24.1%), Pseudomonas aeruginosa (20.7%) and Staphylococcus aureus (17.2%). Multidrug-resistant microorganisms were isolated in 25 (86.2%) episodes, with an emphasis on 66.7% of samples of Pseudomonas aeruginosa, 85.7% of samples of Klebsiella pneumoniae, including carbapenemase-producing samples, 100% of samples of Staphylcoccus aureus, with 80% resistant to vancomycin and 40% to linezolid. All samples of Acinetobacter baumannii were considered pan-resistant. In 2017, 196 patients were admitted to the ICU, 148 (75.5%) of whom underwent to mechanical ventilation, with 46 (31.1%) cases of VAP. Conclusion: The adult ICU of the MHGV has high incidence rates of VAP and microorganisms that are multi-resistant to antimicrobials, requiring more and better epidemiological studies, as well as research on easier and low-cost strategies in their prevention and control. These findings contribute to the appropriate choice of the initial empirical antimicrobial therapy for patients who progressed to VAP in the ICU.
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